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Sri"r�1`�4 •, <br />CITY OF SOUTH BEND <br />jam: <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-1.0 <br />MBE UTILIZATION PLAN <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is <br />the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number. 119-031D Project Name: Drewry's Brewery Cleanup Phase II Bottling House Demolition <br />Bidder. r'.,' Total Bid Amount: -(o l �'� MBE Goal: 1.36% <br />Page / of <br />Name & Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />y(/j <br />%Cf%jl <br />r7 <br />I! <br />i <br />4` <br />Af <br />Submitted by: 47/k All-, <br />Print Name <br />/ // <br />Signature <br />***Goals should be calculated based on the <br />Version 07/19/2023 Contractor's Bid for Public Works - 8 <br />Bid only.*** <br />Date <br />_ 6 �L <br />ex L4 <br />